911 Woodshop Trauma
Location: Rancho Cordova, California Date: September 10, 1991 Story On September 10, 1991, 20-year-old Doug Rheams, a carpenter in Orangevale, California, discovered that even a very severe open wound need not be fatal, or even critically disabling, if appropriate emergency care is given at the scene of the accident. In the afternoon, Doug was working, cutting lumber with a power saw at the Redwood Shop, a carpentry shop specializing in custom decks and gazebos. In the office adjoining the workroom, Lori Barudoni, one of the owners of the shop, was doing some paperwork. Lori and Doug were alone in the shop that afternoon, and she came in to ask him about his weekend, which he told her had not been a good one--his dog had been run over by a car, and when he went to help it, it bit him. Lori went back to the office and became absorbed in her work. Suddenly, the noise of the power saw was punctuated with a loud, terrifying scream. "It was unlike anything I'd ever heard anywhere in my life," Lori said, "and I knew that he'd cut his hand off, even though I wasn't in the same room with him." Lori ran into the workroom, where Doug was holding his hand and crying in pain as blood spurted from his wrist. She ran back into the office and immediately called 911. Sacramento County dispatcher Victor Bauthier took the call. "He cut off his hand," Lori yelled into the phone; then, responding to Bauthier's questioning, gave him the address of the shop. "You've got to get here quick," she added, still yelling excitedly. "She was a little out of control," said Bauthier. "At times, you have to go in there and bully--tell them, 'You need to be calm. We're trying to help the person, and we need you to be calm so we can help him.' " "Where is he?" Bauthier asked her. "He's in the workroom." "Good. Do you have a clean towel? What I want you to do is wrap a towel around his-" "We don't have any towels," Lori interrupted Bauthier. "Paper towels? Anything of that nature?" Bauthier asked. "Nothing--just toilet paper," Lori answered. "No, that won't do," said Bauthier. "Do you have a T-shirt or anything like that?" he asked, trying to identify something Lori might have on hand that would enable her to put direct pressure on the wound. "Yes, yes, we have that," she said. "Good. How bad is the hand? Is it off?" he asked. "I don't know," Lori answered. "I want you to wrap it up," Bauthier instructed her. Lori told Doug to take off his shirt, and wrapped it around his wound. "What do you want me to do now?" Lori asked Bauthier, adding, "I think he's gone into shock." "We want him to lie down," Bauthier answered, articulating each word slowly but forcefully, making certain that Lori both heard and understood. "Come on, Doug, I want you to lie down--on the ground," she told him, trying to control her panic and worrying that she herself would pass out from the sight of the blood. "I've got to stop the bleeding! I've got to stop the bleeding!" she cried out loud. "I thought that he had probably ruptured the artery, because of the way the blood was coming out," Bauthier said. "Don't put a tourniquet on it," he told Lori, worried that she would do something that could cause permanent injury. "You don't want to tourniquet things except as a last resort," he explained. "I've got his shirt on it," she said. "Just wrap it around," Bauthier said, "and apply pressure." "Pressure," Lori repeated, following his instructions. "Apply as much as you can, and don't stop. Now I want you to keep him flat, and he is--" "Okay." "--and elevate his legs about 18 inches," Bauthier continued. "I'm putting them on the bench," Lori said. "You're doing good work," Bauthier said in encouragement. "He keeps saying he's going to die," Lori said, agonized. "No," Bauthier said calmly and reassuringly. "You tell him we're not going to let him do that." "We're not going to let you do that," Lori said, turning to Doug. "You're just nervous--you're just in shock." "It's against my rules," Bauthier added jokingly. "You're not going to die--you're not!" Lori repeated to Doug. "His eyes kept rolling back in his head, and I would say, 'Come on, Doug, come on,' and his eyes would come back. I knew that if I lost it, there would be no one there to help him," Lori said. "Does he know how much he cut?" Bauthier asked her. "How much did you cut, Doug?" she asked him. "About all the way through," he told her. "About all the way through," she repeated to Bauthier. "The hand has not been basically amputated, right?" Bauthier asked, trying to get a clear picture of the injury. "It's through the bone," Lori said. "Through the bone--so it's hanging pretty much by the skin?" "Yes," Lori said, and then turned all her attention to comforting Doug. "Just think of evertbody that's on their way here that's going to take care of you," she told him. "They've got a whole crew coming." "That a girl--good work," said Bauthier, who could hear her through the phone, encouragingly. "So just hang on," she told Doug. "I'm going to die," he said, in agony and panic. "No, you're not going to die," she said firmly. "We're not going to let that happen." "Good girl," said Bauthier. "Good girl." It's okay," she said to Doug. "It's going to be okay. Let's say a prayer, okay?" "Okay," Doug responded weakly. "Oh, dear Lord, please help Doug right now," Lori prayed aloud. "Help him to get through this. Take his hand and walk with him. Give them godspeed on the way here." "When she started saying that prayer, that was the thing that got to me most on that phone call," Bauthier said. "Tell the ambulance to hurry," Lori said. And within moments, she and Doug could hear the siren of the rescue unit from the Sacramento County Fire Department. "They're here," she said to Bauthier, hearing the sound in the street. "Can I leave him here?" "No, no, no," he told her. "I want you to hang in along with me until they get to him." "They're here," she said again, as the rescue team walked through the door. "Okay," Bauthier said. "He says it's through the bone," Lori told the rescue team. "He's concerned that he's lost too much blood." "We're going to take care of him," said one of the team reassuringly. "When I heard John's voice, I knew she was in good hands," Bauthier said. "Okay, good-bye," he told Lori. "Good-bye," she said, relief evident in her voice. "Looking at the scene, and the amount of blood on the floor and on the wall, I estimated that he had lost 15% of his blood volume," said one of the rescuers. "With arterial bleeding, a person could die within a few minutes from loss of blood. We virtually constructed a splint from the lower part of his arm all the way to his fingertips. Doug was very pale. He was telling us that he didn't want to lose his hand. He was telling us that he didn't want to die." Doug was taken by LifeFlight helicopter to the trauma unit of the University of California Davis Medical Center, where his father, Russ, was waiting for him. "Before they took Doug into surgery, he looked at me and said, 'Well, I guess I'm going to lose my hand.' And I said, 'No, no, no, you're not going to lose your hand. Everything's going to be all right. Don't worry about it.' And all the time I was thinking, 'Yes, you are going to lose your hand.'" Chief orthopedic surgeon and hand specialist David Steinberg performed the operation. "If this had happened 20 or 30 years ago, I think his chances of having a functional hand would have been greatly decreased," Steinberg said. "Technology is now advanced enough that we expect a fair degree of success from this operation." Ten months after Doug's hand had been reattached, he had regained partial use of it, and was anticipating recovery of 90% to 95% of full function, and a return to his carpentry work. Most important, he was grateful to be alive. "I was real scared that I was going to bleed to death," Doug said. "It's a good thing Lori was there--I really appreciate what she did. I couldn't have made it without her." "I don't think I did anything extraordinary," Lori said. "I think I did what I was told--and I called 911. That's the great thing. Once you get hold of them, they'll tell you what to do." "To me, that's all the gratitude I ever need," said Bauthier. "Just so long as I know that things have worked out and that the help was there for them. That's what my job is all about--helping people." "You can't be too careful when you're working around equipment like that," Doug said. "No matter how much of a habit you've gotten into of doing the same thing every day, it's still dangerous. You've really got to pay attention to what you're doing and take your time." "From the very first day, I was teasing him about what a lousy way to get out of working for a living--to try to cut your hand off. But the teasing is all a cover-up so I don't have to think about what I'm really feeling," said Russ. "What I'm really feeling is, I could have lost my son." Category:1991 Category:California Category:Bleeding